More and more young people are seeking help. ‘Our 147 counselling service has been receiving a growing number of enquiries since Covid,’ says Dino Demarchi, Head of Public Relations at Pro Juventute. Young people are increasingly preoccupied with profound problems: Today, the counselling service receives an average of 13 enquiries per day from young people with suicidal thoughts. This is more than three times as many as before the pandemic. This is having an impact on crisis interventions. They have reached a record high. Five years ago, it was necessary for an emergency service to be deployed once a week.
Today, we have to call them in every other day,’ says Demarchi. ‘We are watching developments with great concern. And it shows the importance of easily accessible counselling services.
Dino Demarchi, Pro Juventute
The 2022 health survey conducted every five years by the Federal Statistical Office also recorded a general increase in the number of people with mental stress. Alessandra Weber, Managing Director of Kinderseele Schweiz, points out that there has been an increase among young people between the ages of 15 and 24 in particular: 22% are affected. Kinderseele Schweiz is committed to the mental health of children and young people. The focus is on those with parents who are under mental stress. Weber mentions various possible reasons why this group is particularly seriously affected.
The restrictions during the pandemic, the increasing pressure to perform at school and in education, and the generally tense global situation.
Alessandra Weber, Kinderseele Schweiz
Crisis after crisis
Climate change and the war in Ukraine, the decline of democracy and economic warfare – the overlapping of various crises is shaping the current situation. This multi- or permacrisis is affecting children and young people. The decisive factor, however, is not the sheer amount. Emotional stress is increasing as information enters the daily lives of young people through different channels. Thomas Ihde, Chair of the Pro Mente Sana Foundation Board and Executive Chief Physician of Psychiatry at Spitäler Frutigen Meiringen Interlaken, explains: ‘In a 30-second Tiktok video, you’ll see a young man talking about life in Gaza.’ The videos convey the feelings of the experiences. Emotional distance fades. Even journalistic vehicles such as Tagesschau would focus on people’s feelings instead of providing objective reporting. ‘This is a new phenomenon,’ says Ihde. It causes stress and strain. You have to endure with negative feelings together. However, this does not necessarily make sense. He says:
That’s why the ability to regulate my feelings is much more challenged today.
Thomas Ihde, Pro Mente Sana, Psychiatry Spitäler Frutigen Meiringen Interlaken
Last year, Pro Juventute investigated how young people are doing in the youth study published for the first time. According to the study, young people spend four to five hours a day online. ‘That’s why it’s important that they learn how to deal with the media healthily at an early stage,’ says Dino Demarchi. ‘They need to be able to distinguish credible sources from fake news. They must be able to shape their media use constructively.’ The evaluation shows positive experiences with social media. ‘50% of respondents use the channels to maintain contacts and friendships, which is viewed positively,’ he says. 20% have even made new friends via social media. But 14% say that they perceive social media as a stress factor. The study also shows that around a quarter are concerned about the state of the world and society. The results reveal differences. Women respondents are more concerned about injustice, lack of tolerance and the future in general. For young men, political developments, social division, disinformation and artificial intelligence are more important. Despite the strain caused by global developments, the biggest stress factors are school stress, general pressure to perform, financial worries and one’s own future prospects. These are the factors on which the security of one’s own position depends. Dino Demarchi says: ‘There can be pressure to perform in order to attain a secure position in a world shaped by uncertainty. And that can be mentally stressful.’
Focus on families
For young people, it is the family that should provide a sense of security. For As’trame, it remains a central unit of society. This is where the foundation gets involved. In French-speaking Switzerland, it offers mental health support to children, young people and their families in the event of a death or serious illness, mental illness of a relative, or parental separation. Children are particularly affected by these misfortunes. As’trame also notes an increase in the number of cases. To reach children and young people affected, the foundation focuses on raising awareness among professionals who are already in contact with these families. ‘So far, little has been done for the children,’ says Anne de Montmollin, Managing Director of As’trame. ‘They often go under the radar. That’s why we’re raising awareness among professionals. This is one reason why we have more cases.’ But the consequences of the pandemic are still being seen. It took a toll on many families.
So far, little has been done for the children.
Anne de Montmollin, As’trame
Breaking down prejudices
Families are essential to children’s well-being. Parents are therefore also a particular focus at Kinderseele Schweiz. ‘Parents with mental health conditions have a particularly difficult time,’ says Alessandra Weber. ‘They are quick to be pilloried in public discourse. Their ability to bring up children is questioned or it is even suggested that they should not have had children. That’s absurd.’ Many of those affected would wait a long time to seek help because of these prejudices. They would only react if they were no longer able to cope with the various pressures at all. ‘That’s not good for them or the children,’ says Weber. She emphasises that people with mental health conditions can be just as good and loving parents as those who do not suffer from them. Sometimes they just need temporary support. Even though these prejudices still exist, Weber has noticed a change in the last ten years. A greater openness to the issue of mental health has become established in society. ‘The issue is being addressed in the media more and more, especially since the pandemic,’ she says. The pandemic has reinforced this issue on many levels and encouraged various developments. Thomas Ihde sees the direct impact of the pandemic on the mental health of those affected. Depending on the region and the measures in place, the impact on the lives of young people and children varied. Today, the pandemic is seen more as a catalyst for existing trends. ‘There was a leap in development that began a long time ago,’ says Ihde.
Stronger stigma
Increased attention to the issue of mental health during the pandemic has led to a destigmatisation of the issue. However, this needs to be considered in a differentiated way. The stigma has changed. Thomas Ihde notes a reduction in stigmatisation associated with other people’s mental health problems. Young people in particular react sympathetically to a friend who is experiencing a mental crisis. At the same time, tolerance towards people with severe mental health problems or conditions has fallen. Conditions such as borderline or schizophrenia are even more stigmatised today. For a young person with a diagnosis of this kind, it is more difficult to find a job today than it was 30 years ago. Our society may be becoming increasingly tolerant. At the same time, life is shaped by increasingly narrowly defined performance expectations. This has consequences for children and young people. ‘Childhood is also getting shorter and adolescence longer,’ says Ihde. ‘Today, we see six-year-olds having a day structured around performance by appointments such as violin lessons.’ Self-stigmatisation also remains high, he says. ‘If we have trouble sleeping or our thinking becomes increasingly negative, we still have trouble asking for help,’ says Ihde.
Intolerance can also put a strain on children within the family. For example, if a parent is suffering from mental stress, but this cannot be spoken of at home. This puts a strain on children. ‘They are loyal to their parents – no matter what they experience at home,’ says Alessandra Weber. ‘That’s why it’s rare for children or young people to contact us directly. The children are dependent on adults looking at their surroundings, recognising that the situation is stressful for them and arranging appropriate support.’ At Kinderseele Schweiz, it is the parents themselves who get in touch in just over half of the cases. Other experts include teachers, school social workers, family doctors, paediatricians, psychotherapists – and people in the social circle of families affected. The decisive factor is always when the family gets help. ‘The longer the wait, the greater the risk that the family stress has already had a negative impact on the children’s health,’ says Weber. ‘Help works best and fastest when parents recognise that the situation is potentially harmful to their children’s health and are open to seeking help for themselves and their children.’ If this is not the case, the children need another adult caregiver who can be reliably there for them. They must be able to talk openly about their mother or father’s health. ‘Children who understand the situation and know that their experience is related to a health condition are generally better able to cope with it,’ says Weber. This can protect children from becoming ill themselves.
Change, not conflict
Children and young people also rarely get in touch with As’trame. Parents are the ones who call, sent by professionals or at their own initiative. Anne de Montmollin says: ‘We are well known in schools and crèches today. Parents can also find us online or get a direct recommendation from another family.’ As’trame’s approach has two focuses. One is on children. They should be able to integrate what they have experienced in the course of their lives. The child receives the necessary support, which is specifically tailored to the needs of their age. This includes groups with other children. This helps them realise that they are not alone in their situation. As’trame’s second area of focus is working with the family. They provide support for parents. The aim is to approach problems together in the family and thus strengthen it. ‘Following events such as a death or separation, the family has to reorganise itself. We work with this dynamic,’ says de Montmollin. The focus is always on making a lasting impact on the children affected by putting the family back on a stable footing. Children are highly adaptable. For instance, the death of a family member is awful. For children, this experience can be very difficult. But after that, they can get back on their feet once they have a stable family reference point again.
If the parents separate, the child is challenged by the new life structure. They can adapt to a new situation if the situation is stable and their needs are taken into account. ‘But they can’t adapt to a conflict,’ says de Montmollin. ‘Especially if the conflict between two parents lasts for a long time. This will have a very negative impact on the child.’ As’trame notes that children who have been exposed to this kind of situation for years often have great difficulties. In order to achieve a lasting improvement for these children, As’trame works in coordination with other professionals and services. ‘We work systemically,’ she says. ‘We see the child in the family. We take into account the family’s network and we strive to ensure that all professionals who work with the families work in the same direction.’
Sustainable funding
As many of the families who benefit from As’trame’s services are in difficult financial situations, the registration fee is in line with their capacity. ‘Nevertheless, it is important that those affected pay a contribution themselves,’ says de Montmollin. On average, families pay 20% of the costs. The rest is covered by state funds, foundations and donations. Pro Mente Sana also has various sources of funding. As an independent mental health organisation, it is a point of contact for people with mental health conditions and their relatives. It also advocates for its interests politically. ‘People with schizophrenia or manic depression don’t have a lobby,’ says Thomas Ihde. ‘Mental illness is also a difficult topic when it comes to collecting donations.’
Victim of their own success
After the pandemic, the foundation ran into financial difficulties due to increasing demand and a lack of funding. It became a victim of its own success. Demand for its services rose sharply. However, funding remained stable. ‘When we were needed the most, we had to get the foundation back on its feet,’ says Ihde. With the Clivaz motion, the National Council has tasked the Federal Council with developing funding for national advisory and counselling services in the long term, as the range of treatments on offer still does not cover demand. This makes accessible initial points of contact such as Pro Mente Sana, Pro Juventute and Dargebotenen Hand all the more important. Pro Juventute observes. ‘It’s difficult to find a place,’ says Dino Demarchi. The demand is there. Currently, one in ten young people is receiving professional treatment and one in three has already received such treatment. ‘When we see that the number of calls is growing overall, and especially regarding serious issues, it is a clear sign that we need to act here to support the mental health of children and young people.’
Anne de Montmollin still recognises a lack of awareness of the problems faced by children in difficult circumstances. There is still not enough being invested in improving mental health in this situation. However, she also sees potential: The problem can be overcome if intervention comes in time. ‘Our job is to listen and advise, but also to identify resources and help those affected to activate them in order to overcome their difficulties. This is the type of action we want to promote.’
